DSA定位下不同原因食管气管瘘内支架置入的临床应用

目的:分析DSA定位下不同原因食管气管瘘内支架置入的临床应用效果.方法:选择2012年1月~2017年1月进入我院的食管气管瘘患者21例作为研究对象,采用DSA定位下进行支架置入,分析置入效果.结果:21例研究对象其中20例一次性置入成功,支架膨开良好,对比通过顺畅,术中无大出血、食管穿孔等并发症发生.所有患者均在术后出现不同程度胸骨后疼痛,经临床对症处理后2~5天后续缓解.1例未成功置入患者瘘口仍存在,术后2个月死于肺部感染.另外20例其中2例在支架置入后32天出现大出血,经过积极抢救仍死亡.其余18例随访发现进食梗阻等临床症状得到明显改善,但5例因多器官功能衰竭死亡.结论:在DSA定位下对不同原因食管气管瘘内采用支架置入可获得良好临床效果,但是仍然需要根据患者个体情况选择合适类型和直径的支架.

Clinical Application of Stent Placement in Esophagotracheal Fistula with Different Causes Under DSA Location

Objective:To analyze the clinical application effect of stent implantation in esophagotracheal fistula with different causes under DSA localization.Methods:21 cases of patients with esophagotracheal fistula admitted to our hospital from January 2012 to January 2017 were selected as research objects,and stent implantation was performed with DSA localization to analyze the implantation effect.Results:Among the 21 cases,20 cases were successfully implanted at one time,the stent expansion was good,and the comparison was smooth.All patients presented varying degrees of post-sternal pain after surgery,which was subsequently relieved 2~5 days after symptomatic clinical treatment.One patient still had a fistula without successful implantation,and died of pulmonary infection 2 months after operation.In the other 20 cases,2 cases presented massive bleeding 32 days after stent implantation and died after active rescue.Follow-up of the remaining 18 cases showed significant improvement in clinical symptoms such as feeding obstruction,but 5 cases died due to multiple organ failure.Conclusion:Stent placement in esophagotracheal fistula with different causes under DSA localization can achieve good clinical results,but it is still necessary to select appropriate types and diameters of stents according to individual conditions of patients.